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03-10-2016 | Original Article

Cognitive Control and Anxious Arousal in Worry and Generalized Anxiety: An Initial Test of an Integrative Model

Auteurs: Michael W. Vasey, Lyvia Chriki, Gim Y. Toh

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 2/2017

Abstract

Pathological worry is thought to persist, in part, because it fosters avoidance of unpleasant internal experience. However, current models disagree as to whether worry serves that function because: (1) it suppresses high levels of autonomic arousal (AA) symptoms or (2) it leads to persistent heightened AA symptoms. In fact, pathological worry and generalized anxiety disorder (GAD) are linked to both high and low levels of AA symptoms. To account for this heterogeneity, we propose an integrative model, which predicts that AA symptoms vary as a function of the worrier’s capacity to perform the subtle cognitive maneuver necessary to avoid such arousal. We review evidence supporting this model and report an initial test in a large college sample. Our results provide clear support for the major premise of our model: AA symptoms in worry and GAD vary as a function of individual differences in cognitive control capacity.

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However, evidence suggests that these response domains show higher concordance among individuals with high trait anxiety, which is a close correlate of worry (Calvo and Miguel-Tobal 1998).

Because individuals scoring above the median on NA and in the upper or lower quartile on the ECS-PLD scale were disproportionately invited to participate in this subsample, our total sample may have had somewhat more individuals than is typical having both high NE and either high or low EC. Thus, we likely had somewhat higher statistical power to detect an interaction involving variables associated with heightened NE (such as worry) and varying levels of EC than would be typical (see McClelland and Judd 1993). Consistent with this, 5.67 % of Sample 1 qualified for membership in our analog GAD group versus 10.64 % of Sample 2.

As described in the supplementary material, we also considered DASS depression (DASS-D) scores.

The duration criterion has been called into question (e.g., see Andrews et al. 2010).

The pattern of all results was unchanged if the covariate was omitted.

See the online supplement for consideration of alternate models.

See the online supplement for a test of the GADQ-IV Score x EC interaction predicting DASS-D scores in the GAD group. The interaction was not significant.

The PSWQ × EC interaction was not tested in the GAD group due to the restriction of range on the PSWQ imposed by our approach to identifying members of the GAD group (i.e., one requirement was PSWQ ≥ 70).

See the online supplement for analyses predicting DASS-D scores. EC significantly moderated the association between PSWQ/GAD symptom severity and DASS-D scores.

This implies that worry and AA symptoms may interact to predict declines in cognitive control over time. As discussed in the online supplement, the current study did not provide an appropriate context in which to test such a prediction.

As discussed in the online supplement, we tested an alternate model in which AA symptoms interacted with EC to predict level of worry. The DASS-A × EC interaction was significant and produced a pattern consistent with expectation.

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Titel: Cognitive Control and Anxious Arousal in Worry and Generalized Anxiety: An Initial Test of an Integrative Model
Auteurs: Michael W. Vasey
Lyvia Chriki
Gim Y. Toh
Publicatiedatum: 03-10-2016
Uitgeverij: Springer US
Gepubliceerd in: Cognitive Therapy and Research / Uitgave 2/2017
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI: https://doi.org/10.1007/s10608-016-9809-6

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